County of Sacramento

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1 Internal Services Department of Personnel Services Employee Benefits Office Dave Comerchero, Manager County of Sacramento September 2014 Dear Employee: Open Enrollment begins September 29, 2014 and ends October 24, Open Enrollment is the time of year all employees have the opportunity to make health plan changes without a qualifying event. As a result of last year s changes in medical carriers, there are only very modest increases in the 2015 medical plan premiums, and all High Deductible Health Plans remain available with no payroll deduction if you are in Tier B status. New for 2015 is an additional 5 times salary level for Optional Life Insurance, a new Limited Purpose Flexible Spending Account and brand new Critical Illness plan. We encourage you to read this information as well as the 2015 MyBenefits Summary thoroughly to provide enough time for you to ask questions, attend events and select the coverage you prefer for IMPORTANT INFORMATION FOR 2015 Medical carriers and plans are unchanged for Kaiser, Sutter Health Plus and Western Health Advantage will be available in both Traditional $15 HMO co-pay plans and High Deductible HMO plans. High Deductible and Waiver participants may still elect Optional Vision coverage under VSP. You should carefully review the annual difference in payroll deductions between Traditional and High Deductible plans to determine which plan type makes sense. If you are satisfied with your current coverage, you do not need to make a medical or vision plan change. The maximum annual contribution to a Health Savings Account (HSA) for 2015 has increased by $50 to $3,350 for individual coverage and by $100 to $6,650 for family coverage for participants under age 55. Remember, you are only allowed to contribute to a Health Savings Account if you are enrolled in a High Deductible Health Plan and have no other disqualifying coverage. The County is adding a new Limited Purpose Flexible Spending Account (FSA) for This account functions the exact same way as our current General Purpose Medical Reimbursement Account with identical grace periods and use or lose rules, except it is only allowed to reimburse qualified dental and vision expenses. The key benefit is that for the first time you can have a Limited Purpose FSA and still contribute to a Health Savings Account at the same time. This allows you to keep a larger amount of your versatile HSA funds in reserve over a longer period of time and still be able to set aside FSA funds for dental and vision expenses. Additional information about the Limited Purpose FSA is in the 2015 MyBenefits Summary. 700 H Street, Suite 4667, Sacramento, California Phone (916) Fax (916) California Relay Service

2 The County has negotiated a reduction of approximately 5% in the rates for Optional Life Insurance offered by Prudential, in conjunction with an increase to a new 5 times salary level with a maximum $600,000 in coverage. As a result, County employees will be able to make an election online to increase their current Optional Life coverage by one step with no medical underwriting or evidence of insurability required (Note: you must not have been previously declined by underwriting). This is an excellent opportunity to ensure you have the appropriate coverage in place. For the first time, the County is providing a Critical Illness plan offered by Prudential. This voluntary plan uses post tax deductions and provides tax free lump sum payments upon the occurrence of certain illness such as heart attacks, strokes, and cancers. Coverage is available for the employee, spouse/domestic partner, and children in set increments, and is age rated with guarantee coverage limits. You may elect this coverage online, and will even be able to receive an immediate answer if requesting over the guaranteed issue limits. This benefit can provide critical financial assistance when dealing with medical related issues and absences so please review the material carefully to determine what level of coverage is appropriate for you. Again for this year s Open Enrollment, those employees increasing their contribution amounts in the County s 457(b) Deferred Compensation Plan will be entered in a raffle drawing in support of National Save For Retirement Week October Fidelity Investments has recently enhanced the online retirement Planning and Guidance tools available to you at so you can see what impact your changes can make to your 457(b) account. As always, remember that you can schedule a one on-one meeting with a Fidelity Financial Planner at to ensure your retirement goals are on track. THINGS TO KNOW A copy of the 2015 MyBenefits Summary is enclosed with these Open Enrollment materials. This booklet is a valuable resource and can answer many of your benefits questions. The medical plan premiums for 2015 are on page 8 and information for the Critical Illness plan starts on page 22. Benefits changes should be made using BenefitBridge at at work or at home. BenefitBridge has a revamped look and feel this year for Open Enrollment and instructions for logging in to BenefitBridge and navigating through the system are available at The deadline to make Open Enrollment changes is October 24 at 5:00pm. If you are adding a dependent to your coverage, the enrollment is not complete until you submit the required dependent documentation (birth certificate, marriage certificate. etc.). Your dependent documentation must be submitted and into our office by October 31 at 5:00pm. Failure to submit the required documentation by the deadline will result in your dependent not being enrolled, and your enrollment request may be denied.

3 If you are waiving your medical coverage, after making your online election to waive you must submit proof of your other group coverage by October 31 at 5:00pm. Other group coverage generally means coverage from another employer group or retiree plan. Purchasing coverage through an individual plan or on the Exchange is not considered group covered for purposes of waiving the County sponsored medical benefit. HOW TO GET HELP There are several resources available to assist you during Open Enrollment: Employee Benefits Office website Carrier Resources Contact the carrier directly to get your questions answered; phone numbers and websites are in the back of the MyBenefits Summary book. Open Enrollment Events Benefits Staff and carrier representatives will be at the below events to answer any questions you may have: DATE TIME LOCATION Sept 30 Tuesday 9am-12pm DHHS 7001 East Parkway October 1 Wednesday 9am-12pm County Admin 700 H Street-Lobby October 8 Wednesday 7am-11am Sewer District (new) Goethe Road October 14 Tuesday 9am-12pm Granite Park 3331 Power Inn Road All carriers will be present to answer questions If you need personal assistance you may contact the Benefits staff Monday Friday 8am -5pm by at MyBenefits@saccounty.net or by calling Due to the high volume of inquiries please allow hours for a response. Sincerely, Dave Comerchero Employee Benefits Manager DISCLAIMER Information contained in this mailing is confirmed as of the date of print. We strive to provide you accurate information as timely as possible. Benefits are subject to the schedule of covered services and exclusions as prescribed in the applicable Evidence of Coverage (EOC) from the applicable carriers.

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5 Internal Services Agency Department of Personnel Services Employee Benefits Office Dave Comerchero, Manager County of Sacramento September 10, 2014 RE: NOTICE OF CREDITABLE/NON CREDITABLE COVERAGE; MEDICAID-CHIP OFFER OF NO OR LOW COST COVERAGE As an individual eligible to participate in the group medical insurance program sponsored by the County of Sacramento, we are required to send you the attached Creditable/Non Creditable Coverage notice in accordance with the Medicare Prescription Drug Improvement and Modernization Act of If either you or a covered dependent are eligible for Medicare Part A and/or enroll in Medicare Part B, this letter and the attached Creditable/Non Creditable Coverage document contain important information. Please read this information carefully to understand your options. In addition, if you are eligible for health coverage from your employer, but are unable to afford the premiums, some states have premium assistance programs that can help pay for coverage. The attached document contains important information regarding Medicaid or CHIP programs to help people who are eligible for employer-sponsored health coverage. Please read this information carefully to understand your options. If you are currently enrolled in a Kaiser, Sutter Health Plus, Western Health Advantage or UnitedHealthcare medical plan through the County of Sacramento group medical insurance program, the prescription drug coverage under this program is as good as, or better than, the coverage provided under the new Medicare Part D prescription drug program. It is creditable coverage as defined by the Center for Medicare and Medicaid Services (CMS), the federal organization that runs the Medicare program. Having creditable coverage will allow you to avoid future penalties for not enrolling in Part D if you are currently eligible to do so. If you currently waived the County of Sacramento group medical insurance program, this is not creditable coverage as defined by the Center for Medicare and Medicaid Services (CMS). You must decide whether to purchase Medicare Part D coverage on your own, enroll in a plan, or possibly risk monetary penalties in the future. If you are enrolled in another group medical insurance plan, please contact the sponsor of your other coverage to determine if their plan qualifies as creditable coverage. Having other creditable coverage will allow you to avoid future penalties for not enrolling in Part D. 700 H Street, Suite 4667, Sacramento, California phone (916) fax (916)

6 If you do not have creditable coverage you must enroll in Medicare D or you will be subject to penalties. The penalty is at least 1% per month for every month that a Medicare eligible person does not have creditable coverage. That penalty is added to the Medicare Part D premium when you subsequently do enroll in Medicare Part D. For example, if you go nineteen months without coverage, your premium will always be at least 19% higher than it would have been had you purchased the coverage. Enclosed is the official notice required by CMS regarding creditable/non creditable coverage. If you have any questions about this notice, or Medicare Part D, you may review the Medicare and You 2015 brochure distributed by CMS, you may call CMS at (800) For information regarding the Medicaid or CHIP programs you can contact your State Medicaid or CHIP office or dial KIDS NOW or contact the County of Sacramento Employee Benefits Office at (916) Respectfully, Employee Benefits Office

7 Important Notice from the County of Sacramento About Your Prescription Drug Coverage and Medicare Please read this notice carefully and keep it where you can find it. This notice has information about your current prescription drug coverage with the County of Sacramento and about your options under Medicare s prescription drug coverage. This information can help you decide whether or not you want to join a Medicare drug plan. If you are considering joining, you should compare your current coverage, including which drugs are covered at what cost, with the coverage and costs of the plans offering Medicare prescription drug coverage in your area. Information about where you can get help to make decisions about your prescription drug coverage is at the end of this notice. There are three important things you need to know about your current coverage and Medicare s prescription drug coverage: 1. Medicare prescription drug coverage became available in 2006 to everyone with Medicare. You can get this coverage if you join a Medicare Prescription Drug Plan or join a Medicare Advantage Plan (like an HMO or PPO) that offers prescription drug coverage. All Medicare drug plans provide at least a standard level of coverage set by Medicare. Some plans may also offer more coverage for a higher monthly premium. 2. The County of Sacramento has determined that the prescription drug coverage offered by Kaiser, Sutter Health Plus, Western Health Advantage and UnitedHealthcare is, on average for all plan participants, expected to pay out as much as the standard Medicare prescription drug coverage pays and is therefore considered Creditable Coverage. Because your existing coverage is Creditable Coverage, you can keep this coverage and not pay a higher premium (a penalty) if you later decide to join a Medicare drug plan. 3. You can continue to waive your medical coverage with the County of Sacramento. However, because you waived coverage, it is non-creditable, you have decisions to make about Medicare prescription drug coverage that may affect how much you pay for that coverage, dependent on if and when you join a drug plan. When you make your decision, you should compare your current coverage, including what drugs are covered, with the coverage and cost of the plans offering Medicare prescription drug coverage in your area. Read this notice carefully it explains your options. When Can You Join A Medicare Drug Plan? You can join a Medicare drug plan when you first become eligible for Medicare and each year from October 15 th through December 7 th. However, if you lose your current creditable prescription drug coverage, through no fault of you own, you will also be eligible for a two (2) month Special Enrollment Period (SEP) to join a Medicare drug plan. If you did not have creditable coverage you may have to pay a higher premium (a penalty). What Happens To Your Current Coverage If You Decide To Join A Medicare Drug Plan? If you decide to join a Medicare drug plan, your current County of Sacramento coverage will be affected. For individuals who elect Part D coverage elsewhere, the County of Sacramento s medical plan will end for the individual and all covered dependents.

8 Your current coverage pays for other health expenses in addition to prescription drugs. If you enroll in a Medicare prescription drug plan, you and your eligible dependents will not be eligible to receive all of your current health and prescription drug benefits. If you drop your current prescription drug coverage and enroll in Medicare prescription drug coverage, you may enroll back into a County of Sacramento benefit plan during an open enrollment period under the County of Sacramento benefit plan. When Will You Pay A Higher Premium (Penalty) To Join A Medicare Drug Plan? You should also know that if you drop or lose your current coverage with the County of Sacramento and don t join a Medicare drug plan within 63 continuous days after your current coverage ends, you may pay a higher premium (a penalty) to join a Medicare drug plan later. If you go 63 continuous days or longer without creditable prescription drug coverage, your monthly premium may go up by at least 1% of the Medicare base beneficiary premium per month for every month that you did not have that coverage. For example, if you go nineteen months without creditable coverage, your premium may consistently be at least 19% higher than the Medicare base beneficiary premium. You may have to pay this higher premium (a penalty) as long as you have Medicare prescription drug coverage. In addition, you may have to wait until the following October to join. For More Information About This Notice Or Your Current Prescription Drug Coverage.. Call the Employee Benefits Office at (916) NOTE: You ll get this notice each year. You will also get it before the next period you can join a Medicare drug plan, and if this coverage through the County of Sacramento changes. You also may request a copy of this notice at any time. For More Information About Your Options Under Medicare Prescription Drug Coverage. More detailed information about Medicare plans that offer prescription drug coverage is in the Medicare & You handbook. You ll get a copy of the handbook in the mail every year from Medicare. You may also be contacted directly by Medicare prescription drug plans. For more information about Medicare prescription drug plans: Visit Call your State Health Insurance Assistance Program (see the inside back cover of your copy of the Medicare & You handbook for their telephone number) for personalized help Call MEDICARE ( ). TTY users should call If you have limited income and resources, extra help paying for Medicare prescription drug coverage is available. For information about this extra help, visit Social Security on the web at or call them at (TTY ). Remember: Keep this notice. If you decide to join one of the Medicare drug plans, you may be required to provide a copy of this notice when you join to show whether or not you have maintained creditable coverage and, therefore, whether or not you are required to pay a higher premium (a penalty). Date: September 10, 2014 Name of Entity/Sender: County of Sacramento Employee Benefits Office 700 H Street, Room 4667 Sacramento, CA Phone Number: (916)

9 Premium Assistance Under Medicaid and the Children s Health Insurance Program (CHIP) If you or your children are eligible for Medicaid or CHIP and you are eligible for health coverage from your employer, your State may have a premium assistance program that can help pay for coverage. These States use funds from their Medicaid or CHIP programs to help people who are eligible for these programs, but also have access to health insurance through their employer. If you or your children are not eligible for Medicaid or CHIP, you will not be eligible for these premium assistance programs. If you or your dependents are already enrolled in Medicaid or CHIP and you live in a State listed below, you can contact your State Medicaid or CHIP office to find out if premium assistance is available. If you or your dependents are NOT currently enrolled in Medicaid or CHIP, and you think you or any of your dependents might be eligible for either of these programs, you can contact your State Medicaid or CHIP office or dial KIDS NOW or to find out how to apply. If you qualify, you can ask the State if it has a program that might help you pay the premiums for an employer-sponsored plan. Once it is determined that you or your dependents are eligible for premium assistance under Medicaid or CHIP, as well as eligible under your employer plan, your employer must permit you to enroll in your employer plan if you are not already enrolled. This is called a special enrollment opportunity, and you must request coverage within 60 days of being determined eligible for premium assistance. If you have questions about enrolling in your employer plan, you can contact the Department of Labor electronically at or by calling toll-free EBSA (3272). If you live in one of the following States, you may be eligible for assistance paying your employer health plan premiums. The following list of States is current as of July 31, You should contact your State for further information on eligibility ALABAMA Medicaid Website: Phone: ALASKA Medicaid Website: Phone (Outside of Anchorage): Phone (Anchorage): ARIZONA CHIP Website: Phone (Outside of Maricopa County): Phone (Maricopa County): COLORADO Medicaid Medicaid Website: Medicaid Phone (In state): Medicaid Phone (Out of state): FLORIDA Medicaid Website: Phone: GEORGIA Medicaid Website: Click on Programs, then Medicaid, then Health Insurance Premium Payment (HIPP) Phone:

10 IDAHO Medicaid and CHIP Medicaid Website: Medicaid Phone: CHIP Website: CHIP Phone: INDIANA Medicaid Website: Phone: IOWA Medicaid Website: Phone: KANSAS Medicaid Website: Phone: KENTUCKY Medicaid Website: Phone: LOUISIANA Medicaid Website: Phone: MAINE Medicaid Website: Phone: TTY MASSACHUSETTS Medicaid and CHIP Website: Phone: MINNESOTA Medicaid Website: Click on Health Care, then Medical Assistance Phone: MISSOURI Medicaid Website: Phone: MONTANA Medicaid Website: clientindex.shtml Phone: NEBRASKA Medicaid Website: Phone: NEVADA Medicaid Medicaid Website: Medicaid Phone: NEW HAMPSHIRE Medicaid Website: Phone: NEW JERSEY Medicaid and CHIP Medicaid Website: dmahs/clients/medicaid/ Medicaid Phone: CHIP Website: CHIP Phone: NEW YORK Medicaid Website: Phone: NORTH CAROLINA Medicaid Website: Phone: NORTH DAKOTA Medicaid Website: Phone:

11 OKLAHOMA Medicaid and CHIP Website: Phone: OREGON Medicaid and CHIP Website: Phone: PENNSYLVANIA Medicaid Website: Phone: RHODE ISLAND Medicaid Website: Phone: SOUTH CAROLINA Medicaid Website: Phone: SOUTH DAKOTA - Medicaid Website: Phone: TEXAS Medicaid Website: Phone: UTAH Medicaid and CHIP Website: Phone: VERMONT Medicaid Website: Phone: VIRGINIA Medicaid and CHIP Medicaid Website: HIPP.htm Medicaid Phone: CHIP Website: CHIP Phone: WASHINGTON Medicaid Website: Phone: ext WEST VIRGINIA Medicaid Website: Phone: , HMS Third Party Liability WISCONSIN Medicaid Website: Phone: WYOMING Medicaid Website: Phone: To see if any more States have added a premium assistance program since July 31, 2013, or for more information on special enrollment rights, you can contact either: U.S. Department of Labor U.S. Department of Health and Human Services Employee Benefits Security Administration Centers for Medicare & Medicaid Services EBSA (3272) , Menu Option 4, Ext OMB Control Number (expires 09/30/2013)

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